Mental Health Support During and After Pregnancy

Mental health and mood changes are very common during pregnancy and in the year after giving birth. One in five birthing people, during pregnancy or postpartum (after birth), experience depression, anxiety, post-traumatic stress disorder (PTSD), frightening thoughts, or other mental health conditions or symptoms. Getting help is the best thing you can do for you and your baby.

Facts About Maternal Mental Health

• Untreated mental health conditions can affect you, your health and your baby’s health.
• They do not mean you are failing as a parent.
• They are medical conditions that can be treated.
• The onset of these conditions can come from a combination of biological, psychological, and social stressors, including lack of support, a family history, or a previous experience with mental health issues.
• Effective treatments are available.

Mental Health Support Options During and After Pregnancy

The words “I need help" are very powerful. If you or your friends or family have concerns about your mental health during pregnancy or after your baby (e.g., what you’re thinking, how you're feeling and functioning), speaking up is the best first step.

• You aren’t alone. Help is available. It’s okay to ask for help.
• Talk to your nurse or doctor, or the baby's nurse or doctor.
• Talk to family, friends and other supports in your life.
• Talk until you are heard.
• Speak with other mothers and learn from what they have experienced.
• Ask family and friends to care for your child for short periods of time and help with chores and errands, giving you time to rest or exercise.
• Don’t expect to be a perfect parent or to pick your life up where it left off before you became a mom.
• Accept that being a parent is difficult and that it’s OK to ask for help.

Support and Treatment Options

• Counseling and talk therapy
• Medication
• Exercise
• Adequate sleep
• Healthy diet
• Bright light therapy
• Yoga
• Relaxation/stress management techniques
• Psychological treatment for you and your family or partner
• Assertiveness training to help you learn how to set limits with family members so you don’t become overwhelmed and overworked
• Coping skill development

It’s essential to get treatment early. Treatment depends on your symptoms and how severe the condition is. An obstetric care provider, primary care provider, or mental health professional can screen, assess, and treat perinatal mental health conditions.

Common Pregnancy and Postpartum Disorders

• Baby Blues: Though not considered a mental health disorder because the symptoms resolve in a few days, up to 80% of birthing people experience “baby blues.” Symptoms include feeling sad, mood swings and crying episodes. If these symptoms persist beyond two weeks, it’s likely depression or another mental health condition.
• Depression: Up to 15% of women experience clinical depression during and/or after pregnancy. Symptoms can range from mild to severe, including sadness, trouble concentrating, difficulty finding joy in activities once enjoyed and difficulty bonding with the baby.

Mothers with preexisting depression before or during pregnancy are more likely to experience depression during or after pregnancy.

• Anxiety: Up to 20% of women have anxiety during pregnancy or after childbirth. An individual with anxiety may experience restlessness, racing heartbeat, inability to sleep, severe worry that may focus on their baby’s health and welfare or not being a good parent.
• Obsessive-compulsive disorder (OCD):  From 3 to 5% of pregnant or postpartum individuals experience unwanted thoughts or feelings (obsession) accompanied by an urge to relieve those thoughts through an action or a “compulsion.” About 50% of women who experience OCD have intrusive thoughts about intentionally harming their infant (e.g., throwing the baby).
• PTSD: About 3.1% of women develop PTSD caused by a real or perceived trauma during delivery or post-partum. These women are troubled by disturbing memories and flashbacks of the event.
• Panic disorder: Up to 10 percent of pregnant women struggle with panic attacks. Symptoms may include a pounding heart, chest pain, difficulty breathing and shaking.
• Postpartum psychosis: Postpartum psychosis is rare, but a severe form of mental illness. Patients may experience extreme confusion, loss of touch with reality, paranoia, delusions, disorganized thought processes, and hallucinations. It’s considered an obstetric and psychiatric emergency.

Related Maternal Mental Health Issues

• Birth loss and grief: Mothers who experience miscarriage or stillbirth are at risk for a variety of mental health disorders in addition to or made worse by grief.
• Intrusive thoughts: Probably the most pervasive condition related to pregnancy and postpartum, 70 to 100% of women have unwanted thoughts that may include those of infant harm, such as dropping or hurting the baby.

Resources

• Massachusetts Behavioral Health Helpline
  • masshelpline.com
  • 833-773-2445 (Call or text | English and Spanish)
• National Maternal Mental Health Hotline
  • mchb.hrsa.gov/
  • 833-TLC-MAMA (833-852-6262) (Call or text | English and Spanish)
• Postpartum Support International
  • postpartum.net
  • 800-944-4773 (Call or text | English and Spanish)
• National 988 Suicide and Crisis Lifeline (formerly the National Suicide Prevention Lifeline)
  • Call or text 988
  • 988lifeline.org
• MCPAP for Moms
  • mcpapformoms.org